The use of honey in treating wounds have been long known, with such use being recorded in 4,000 year old Sumerian clay tablets. There are continuing records of its use throughout history, with an increasing number of medical reports near the beginning of this century. Recently the antibacterial properties of honey and its potential use as a wound dressing has attracted greater attention.
Recent international medical literature record honey as being effective as a dressing for wounds, burns and skin ulcers. Recorded observations include that inflammation, swelling and pain are quickly reduced, that sloughing of necrotic tissue occurs without the need for debridement, and that growth of tissues to repair the wound is stimulated. As a consequence, healing occurs rapidly with minimal scarring, and often without any necessity for skin rafting.
Work by the inventor and others has helped to establish that the effectiveness has been due primarily to anti-microbial properties of honey. Healing processes will not usually occur unless infection is cleared from a lesion, and investigations involving swabbing wounds dressed with honey has shown that infecting bacteria are rapidly cleared.
In this respect honey appears superior to the expensive modern hydrocolloid wound dressings which are favoured in the art as a moist dressing. Although tissue re-growth in the healing process is enhanced by a moist environment, and deformity is reduced if the re-growth is not forced down by a dry scab forming on the surface, moist conditions also favour the growth of infecting bacteria. The difficulty facing the prior art is that antibiotics are ineffective in this situation while antiseptics cause tissue damage and thus slow the healing process. In contrast, honey causes no tissue damage and appears to actually promote the healing process.
While there is a need for moist dressings within the art, investigations involving honey as wound dressings have focussed primarily on unmodified honeys. As mentioned above, dressing wounds with honey has been the most prevalent form of investigation, essentially attempting to maintain raw honey in contact with a wound as part of a moist dressing. However, while such methods may be useful for investigative trials, the techniques can be relatively time consuming to apply and maintain, and may be impractical in a number of situations.
A primary cause of this is the relatively fluid nature of most honeys—i.e. honey is runny at body temperature. Due to this fluidity, especially at body temperature, localising honey to the desired area may be difficult. Difficulties may be less for an incapacitated person in a hospital bed, though these difficulties generally preclude its use as a simple wound dressing on an active person.
Containment of unmodified honey is thus a problem, and no simple practical solution has been proposed. The soaking of absorbent materials, such as gauzes, in a dressing to be applied over a wound and then held in place by a further covering is a possibility though tends to be messy and would be difficult to apply except in a clinical situation. Even then applying such a dressing can be relatively time consuming and require the use of an excessive number of relatively expensive sterilised coverings.
Another problem is that many wounds exude moisture and this causes the problem of further dilution of the honey exacerbating containment problems, especially where there is pressure on the dressing causing the diluted honey to be squeezed out. This dilution of the honey may also introduce other considerations such as a potential reduction in anti-bacterial activity due to dilution.
Accordingly, while the anti-bacterial properties of honey have been acknowledged, there are a number of practical problems to be overcome before honey can find widespread use as a practical dressing for wounds and other medical uses.
Similarly there are a number of problems associated with prior art ‘moist’ wound dressings, such as of the alginate type. The moist environment provided by these types of dressings favours the growth of microorganisms and accordingly they cannot be used on infected wounds, even though this may otherwise be the preferred choice of dressing. The use of many antibiotics have also failed to keep unwanted microbial growth in check when ‘moist-type’ dressings are used in certain situations of this type. Accordingly, medicine cannot always make use of the full potential of moist prior-art dressing types.
Reference will be made throughout the specification to the anti-microbial properties of honey. It is acknowledged that this is known in the art and a number of publications survey these properties. It is anticipated that a skilled addressee of the art would be familiar with the teachings of these publications insofar that many honeys possess antimicrobial properties, with some exhibiting more activity than others. Consequently, this document shall not seek to establish that certain honeys do possess anti-microbial properties, nor shall it seek to set out a specific list comparing the properties of all honeys which may or may not have been publicly documented. Again it will be relied upon that anti-microbial properties associated with honey have been established in the prior art By way of reference, some relevant documents which address this are given:    Molan, P. C. (1992) The antibacterial activity of honey. 1. The nature of the antibacterial activity. Bee World 73 (1): 5-28.    Molan, P. C. (1992) The antibacterial activity of honey. 2. Variation in the potency of the antibacterial activity. Bee World 73 (2): 59-76.    Willix, D. J.; Molan, P. C.; Harfoot, C. J. (1992) A comparison of the sensitivity of wound-infecting species of bacteria to the antibacterial activity of manuka honey and other honey. Journal of Applied Bacteriology 73: 388-394.    Cooper, R. A.; Molan, P. C. (1999) The use of honey as an antiseptic in managing Pseudomonas infection. Journal of Wound Care 8 (4): 161-164.    Cooper, R. A.; Molan, P. C.; Harding, K. G. (1999) Anti-bacterial activity of honey against strains of Staphylococcus aureus from infected wounds. Journal of the Royal Society of Medicine 92: 283-285.
A number of publications describe the large amount of variation in potency of antibacterial activity between different honeys. The variation can be as much as one-hundred-fold, and is due to varying levels of antibacterial factors in honey additional to the sugar content and acidity in which there is little variation.
A patent document of some interest is U.S. Pat. No. 5,177,065 by Silvetti. This document references the manufacture of wound dressings incorporating high levels of monosaccharides. In this document, it is the osmotic properties of concentrated sugar solution which are ascribed as providing any bactecriostatic effect. Consequently the described invention of Silvetti, and claims, concentrate on film-like compositions based on individual monosaccharides or mono-saccharide blends
A very brief reference to honey is made in the prior art discussion of Silvetti, though only in terms of dismissing honey as a folk medicine which would appear to have no useful anti-bacterial effect in a wound healing preparation, such as the subject of that specification. Accordingly, while this document is of some interest, it teaches away from the use of honey in a wound covering form or composition, and instead teaches towards the use of predominantly monosaccharide solutions.
Accordingly, it is an object of the present invention to address the problems associated with the prior art, or at least to provide the public with a useful choice. It also appears from the prior art that the use of honey in a medicinal sense is useful though difficulties associated with its use prevent its full potential from being realised, and hence the present invention also seeks to address this.
Further aspects and advantages of the present invention will become apparent from the ensuing description which is given by way of example only.